Red blood cell transfusion induces abnormal HIF-1α response to cytokine storm after adult cardiac surgery.
Sci Rep
; 11(1): 22230, 2021 11 15.
Article
en En
| MEDLINE
| ID: mdl-34782683
ABSTRACT
Patients undergoing cardiac surgery develop a marked postoperative systemic inflammatory response. Blood transfusion may contribute to disruption of homeostasis in these patients. We sought to evaluate the impact of blood transfusion on serum interleukin-6 (IL-6), hypoxia induced factor-1 alpha (HIF-1α) levels as well as adverse outcomes in patients undergoing adult cardiac surgery. We prospectively enrolled 282 patients undergoing adult cardiac surgery. Serum IL-6 and HIF-1α levels were measured preoperatively and on the first postoperative day. Packed red blood cells were transfused in 26.3% of patients (mean 2.93 ± 3.05 units) by the time of postoperative sampling. Postoperative IL-6 levels increased over 30-fold and were similar in both groups (p = 0.115), whilst HIF-1α levels (0.377 pg/mL vs. 0.784 pg/mL, p = 0.002) decreased significantly in patients who received red blood cell transfusion. Moreover, greater decrease in HIF-1α levels predicted worse in-hospital and 3mo adverse outcome. Red blood cell transfusion was associated with higher risk of major adverse outcomes (stroke, pneumonia, all-cause mortality) during the index hospitalization. Red blood cell transfusion induces blunting of postoperative HIF-1 α response and is associated with higher risk of adverse thrombotic and pulmonary adverse events after cardiac surgery. Clinical Trial Registration ClinicalTrials.gov Identifier NCT03444259.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
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Transfusión de Eritrocitos
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Subunidad alfa del Factor 1 Inducible por Hipoxia
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Síndrome de Liberación de Citoquinas
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Procedimientos Quirúrgicos Cardíacos
Tipo de estudio:
Diagnostic_studies
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Prognostic_studies
Límite:
Aged
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Aged80
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Female
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Humans
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Male
Idioma:
En
Revista:
Sci Rep
Año:
2021
Tipo del documento:
Article
País de afiliación:
Finlandia